Category: Health at Every Size

First of all, this guy is like a stalker, following her around, monitoring her. He’s creepy beyond belief. Secondly, this once again, for the millionth time perpetuates the myth that everyone who is overweight is secretly and guilty sneaking ice cream sundaes. We should know by now that weight is much more complex than that. Thirdly, this shit is just sensationalist. I want to save your life? This woman does not look like she is at risk of dying because of a few extra pounds.

Also, why is it always skinny white guys who have discovered the secret of weight loss and are going to teach it to women?

ETA: I haven’t looked myself, but I’m hearing that the Feministing comments are best avoided. Which is, sadly, not that surprising.

Not everything that is wrong with someone has to do with fat. I do have three chronic illnesses that maybe, just maybe, might be making me feel under the weather. These doctors may have the medical expertise to diagnose an illness but they have no idea what it is to live with one on a daily basis. The fact that they could even suggest that a lack of will stops patients from participating in behaviour that might have the potential to improve health only proves how disconnected they are from how the pain truly affects the body.

It pissed me off. And because this is my blog, I’m about to tell you why.

First, because it’s fucking patronizing.

Second, because it’s a sneaky little divide-and-conquer strategy, of the type commonly used to pit women against other women.

Third, because we’re ALL real women, you fuckwad.

Michelle’s awesomeness notwithstanding, a new study of dietetic students (with a small sample size, so take it with a grain of salt, but still) shows:

More than 40 percent of students reported that they believe obese individuals are lazy, lacking in willpower and are self-indulgent.

The majority of students surveyed also agreed that obese individuals have poor self-control, overeat, are insecure and have low self-esteem.

Students rated obese patients as being significantly less likely to comply with treatment recommendations and as having worse diet quality and health status compared with thinner patients, despite the fact that all patients were described as healthy adults.

Only 2 percent of students demonstrated positive or neutral attitudes toward obese individuals.

HAES UK is a UK-based organisation whose membership is open to all who support its mission. HAES UK supports the Health at Every Size (HAES) approach as an effective, ethical and evidence-based approach to healthcare policy, practice and research. HAES UK is committed to challenging weight-based discrimination which is considered to be disrespectful and harmful to individual and community well-being.

And finally, the book is out in Australia and New Zealand! I heard from a reader in Melbourne this morning:

Have started reading it and love it already. I bought it from a Dymocks (chain of independent book stores…if that makes sense!) in Melbourne city, and they had a lot of them on face-out display.

FACE-OUT DISPLAY, Y’ALL! I can cross that off the list of all-time fantasies, even if I never get to see it. (Hey, if you do see the book face-out somewhere, either edition, would you send us a pic?) One more sleep until it’s out here!

Oh, and hey, our book site — which can be reached via fatosphere.com, screwinnerbeauty.com, and kateandmarianne.com — is live, though there’s not much there you don’t already know. You can also follow fatospherebook on Twitter for updates on upcoming events and media appearances, and/or join our Facebook group.

Because of our delightfully stringentcomments policy, most of the rants about fatties eating everything in a twelve-block radius never make it onto the site. Those “arguments” just aren’t worth thinking about. But we do see some genuine confusion from otherwise reasonable people who can’t see how non-restricted eating could possibly be compatible with health, or indeed with anything but disorder-level binge consumption. Of course, this is just as unfathomable to me as non-dieting is to the diet crowd — isn’t it obvious that Health At Every Size is a much more salutary way to live? — but I recognize that this is a diet-happy culture and going against the Prime Directive like that will always generate cognitive dissonance. So we do try to put some thought into where exactly the disconnect comes from, and we try to loosen some of the knots that keep people bound to a fat-is-bad pro-diet mentality.

To that end, yesterday as I passed by Starbucks I got to thinking about the four hot chocolates I’d thought about getting but not gotten in the last three days. I didn’t get them for various reasons — I was having fun with the person I was hanging out with at Starbucks and forgot to get in line, there were no comfy chairs available, it was raining and I didn’t feel like leaving the office for cocoa, etc. But I know there are people who would affect to be mildly scandalized that I thought with some seriousness about getting hot chocolate four times in three days — even though I didn’t actually get it once. And that opened a window into the fear-of-not-dieting mindset.

See, eating what you want doesn’t mean eating everything you think of. I’ve decriminalized my thoughts about food — I’m allowed to consider getting hot chocolate, or having pie for breakfast, or taking second helpings, without any judgment or shame. But that doesn’t mean I always decide to do those things, and in fact, simply being allowed to think rationally about food means that I often don’t. (Starbucks’ Signature Hot Chocolate is amazing but tragic for my insides; breakfast pie is a brilliant invention but kind of a lot of sugar if you need sustained energy; eating too much food makes me uncomfortable.)

The point is, I think people may be terrified of unrestricted eating because they think “wow, there are so many times that I think about eating — just imagine how fat I would be if I didn’t control myself!” But you don’t have to eat everything that pops into your head, just because you may. As a non-dieter I routinely:

See a commercial on TV for something that looks good, and not only don’t buy and eat it right then but never buy and eat it.

Think about having a snack, but decide it’s too soon until dinner.

Have a sudden craving for something I don’t bother to scare up before the urge passes.

Want to eat a million Oreos, but do not eat a million Oreos because I don’t own a million Oreos and don’t feel like going to the store.

Think about buying something in the grocery store because it looks tasty, but don’t for whatever reason (don’t need it, can’t fit it in my basket, probably not as good as it looks, etc.).

And so forth. The point is that refusing yourself nothing is not the same as giving yourself everything. One thing, one crucial thing I do not refuse myself is the ability to turn things down. I don’t have to eat things just because I have a chance to or I have a notion to or nobody’s watching. Restriction makes you do that, not liberation. And once you’ve let go of the feast-or-famine mindset, it turns out that food is just like other pleasures and other necessities — often worth the trouble, sometimes not, sometimes foregone because it’s inconvenient or costly, sometimes overlooked out of preoccupation or stress, sometimes planned around and sometimes hampered by plans.

A few years ago, a fundamentalist Christian teen organization put out a Modesty Survey that was the subject of much mocking and some horror on the internet. The survey purported to feel out Christian teenage boys on what sorts of dress and behavior they considered “stumbling blocks” in girls — that is, what would tempt them unduly into sin. The picture painted is of a code of decorum so strict as to interfere significantly not just with sexual activity, but with any sort of activity at all. (Among the things found by the majority to be “stumbling blocks”: bending over, sitting cross-legged, lifting your skirt higher than the knee to step over something, showing any cleavage, unspecified “way a girl walks,” unspecified “attitude or behavior.”) Needless to say this was considered problematic for a number of reasons, not least of which is the implication thatbeing reminded of an act that’s considered transgressive amounts to being tempted to do it. A heartening number of respondents said it was their responsibility to avoid lust, not the girl’s responsibility not to provoke it, but the very premise of the survey is that merely being alerted to the possibility of sin is effectively a call to sin, if not a sin in itself. Seeing a girl’s cleavage makes you aware that sex with her is possible, and once you know that, brother, resisting is going to take everything you’ve got.

People who assume that non-dieting is tantamount to wanton indulgence are applying the same non-logic to food that the Modesty Survey applies to sex. Both interpretations require the same unstated axiom: that thoughts about the object of temptation are enough to nullify all self-control, and that control must therefore be externally applied in the form of stringent rules. The ideal outcome is that you never think about the object of temptation in the first place. When you can be brave enough to face your stumbling blocks without a safety harness, though, it becomes clear that thinking about stuff is just thinking about stuff — it doesn’t open the door to sin, it doesn’t compel you to anything, it doesn’t enlist you in a fight you’re bound to lose. It’s not that people who don’t think in terms of “stumbling blocks” don’t think about having sex with every hot person they see — lots of them probably don’t, and lots of them probably do. But they know that thinking about it doesn’t mean they have to do it. All it takes to remain virginal or monogamous or disease-free or unrumpled, or whatever you goal is, is to just not go ahead and fuck everyone you think about fucking. (Assume, in this scenario, that everyone would give consent!) You don’t have to stop looking. You don’t have to stop thinking. You just have to not hump people indiscriminately. If you have a healthy relationship with sex, you probably weren’t going to, right?

Well, if you have — if you can develop — a healthy relationship with food, you’re not going to eat everything that crosses your mind. Forget being unhealthy; it’s not convenient. It’s not necessary. It’s not even particularly plausible. But I think this is where some of the fear comes from, the fear that letting go of restriction means embracing nonstop indulgence, and of course the assumption that that’s what we practice and advocate here. In fact, when you stop seeing everything as a stumbling block, you don’t automatically fall on your face — more often, you can pick your skirt up higher than your knees and just walk on.

There are about a gazillion things we’ve missed in the last week, so it’s round-up time.

First, though, I have a favor to ask of anyone who can swing it. Al’s friend Peter lost his job last July. He and his partner of 20+ years, Ericka, are now in danger of losing their house — foreclosure proceedings have begun, and a sheriff’s sale has been set for May 8. Making matters more difficult, in this case, saving the house isn’t just a matter of keeping a roof over their heads. Quoting Peter:

Ericka has multiple, chronic, life-altering diseases and Peter is her primary caregiver. We have modified our home to handle her medical equipment and power wheelchair, etc. Things like the added and increased voltage electrical system, the ramp, the bathroom, the enlarged doors and added bedroom door (so the wheelchair and ambulance gurneys can get through) are just some of the things that have been adapted so that Ericka can continue to live in our home.

Peter recently got a temporary job, and they’ve received some donations already, but they’re still going to need more to keep the house. I know everyone is struggling right now, but if any Shapelings have a bit of cash to spare, please go here and use the donate button or bid on one of the items other friends are auctioning off. A bunch of small donations could make a huge difference. Also, if you’re in the Twin Cities area and know of anyone looking to hire a webmaster/information architect/business analyst (I don’t even know what two out of three of those things mean), Peter’s resume can be found here.

Nevertheless, I replied that I was reasonably pleased with McCain’s response, overall — although yeah, the “last acceptable prejudice” thing NEEDS TO FUCKING DIE, and it also seemed like there was a little too much, “But I’m not fat!” going on, even though she had the decency to acknowledge that the criticism would be bullshit even if she were. I also admitted that a small part of me quite likes what I’ve seen of Meghan McCain (which is not that much, I hasten to note) — that is, the part of me that thinks deep down she’s a Democrat who’s just a little too green to get why her youthful energy and optimism almost certainly won’t make the Republican party any less hateful in the next few generations — so I might be giving her too much benefit of the doubt. FJ is not similarly impressed. What say you, Shapelings? Is her message refreshing to see, or undermined by the way she articulates it? Or both?

Attack of the fat babies
There are reports out today about a new program designed to keep pregnant women from gaining too much weight. Once again, the reporting suggests that fat moms have fat babies because their fat uteruses are fucking obesogenic environments, not because fat is hereditary. As I’ve said before, I don’t think genetics are the only reason why some people are fat, and I don’t entirely discount the possibility that a woman’s fat cells themselves could potentially affect her eggs or fetus(es). I do, however, think that when we’re talking about fat moms having fat babies, and no one ever says, “Hey, you think maybe that’s because fat is hereditary?” William of Ockham starts spinning in his goddamned grave.

Also, check out Lauredhel on how the supposed upward trend in babies’ birthweights is horseshit.

Brain surgery to cure teh fatz
Today, BFD got around to highlighting Withoutscene’s fabulous rant on the brain surgery for obesity story we still haven’t gotten around to discussing. Discuss.

A good old fashioned blood-boiler
(via Shapeling Judith) Please enjoy this essay, in which Mindy Laube compares fatness to crime AND admits straight up that health is beside the point: Her whole argument is that fat people should rightly hate ourselves on aesthetic grounds alone. Money quote:

When teenage girls are willing to flaunt their oversize bellies in bikinis only one conclusion can be drawn: human nature is in flux. At some point during the last couple of decades, we seem to have misplaced one of the healthiest of human traits: vanity.

Yes, folks, once again, fat is fashionable and thin people are being persecuted by the millions and millions of fat-accepting folks, who are drowning out the noble few still fighting for a thin beauty standard.

The louder crowd insists that slender women are bizarre anomalies who ought to be force-fed into obese conformity because the rotund figure of the average Australian woman is “normal” and thus ideal.

Wow. I know American public schools don’t do such a great job of teaching geography, but I am 34 years old, and until this moment did not even realize that Australia IS ON ANOTHER FUCKING PLANET.

If you’re fat, you should be standing up to burn calories anyway. (If you can’t stand up, fuck you.)
A fitness club in The Netherlands has installed these high-tech bus shelter ads with a scale in the bench that produces a digital readout of your weight up in the usual ad space, where everyone can see it. As Liss says, “Not only fat-hating/shaming, but deeply hostile to the physically disabled, who have to exchange their privacy and dignity for their basic comfort just to wait for a bus.”

Yee fuckin’ haw. Zuzu e-mailed me earlier with the news that Sanjay Gupta has withdrawn himself from consideration for the Surgeon General gig. Both she and Fillyjonk have written about what a fat-hating tool he is, if you’re unclear on why this is a good thing.

Of course, as Liss points out, it’s highly unlikely that whoever does end up as Surgeon General will be one whit less Chicken Littleish about THE OBESITY CRISIS BOOGA BOOGA BOOGA. But I’ll drink a wee tiny glass of champagne for this one anyway.

If you read the paper in the mornings, you may already have seen the news — the latest issue of the New England Journal of Medicine includes a study showing that all diets work the same, it’s only calorie intake that matters.

Some previous studies have found that low carbohydrate diets like Atkins work better than a traditional low-fat diet. But the new research found that the key to losing weight boiled down to a basic rule – calories in, calories out.

“The hidden secret is it doesn’t matter if you focus on low-fat or low-carb,” said Dr. Elizabeth Nabel, director of the National Heart, Lung and Blood Institute, which funded the research.

Limiting the calories you consume and burning off more calories with exercise is key, she said.

In between quotes like this and “success stories” from two program participants, this particular article does get around to mentioning that all participants started regaining weight after a year. Some articles don’t. The version I saw in the commuter paper coughed and whispered it at the end, but headlined with “All diets the same!” and touted the supremacy of calorie counting. Most people who read coverage of this study could be forgiven for coming away thinking that no matter how many carbs you eat, what really matters is staying below a set number of calories — just another version of “well, FAD diets don’t work, but I’m just on a regular calorie-counting diet so it’ll work for me.” Because for the most part, that’s what the articles say.

The study only followed people for two years, not five, but already saw weight regain in almost all participants. Nor were they surprised. The researchers said that they chose a two-year period because “weight loss typically is greatest 6 to 12 months after initiation of the diet, with steady regain of weight subsequently.”

Participants in every group were on average eating FEWER calories at the two-year mark, when they were regaining, than they were at the six-month mark, when they were still losing weight. (ETA: Almost every group. Kate double-checked me and one group was eating about 22 calories more on average at two years than at six months.) (ETA: No, I was right the first time.)

ETA: From MissPrism: “They also wouldn’t let ‘insufficiently motivated’ people on the study to begin with, and haven’t published the questionnaire or criteria that they used to determine level of motivation.” Depending on the definition of “motivated,” this could easily disqualify anyone who practices HAES.

The Globe and Mail coverage reported this as “all diets work.” It looks to me more like “no diets work.” And hey, that’s how it was reported last time someone did this study, less than two years ago, when researchers analyzed the results of 46 different weight-loss studies and found that there wasn’t much difference between various diets because they all sucked. It’s interesting how “there’s no material difference between diets” is now being reported now as “all diets work as long as you cut calories,” even though the primary desired effect of diets — weight loss — isn’t being observed on even fairly short time scales. How, pray tell, does that mean diets “work”? A broken Ford and a broken Honda both “work the same” too, but since neither of them does what they’re designed for, we call them both lemons.

Now granted, they did find that the participants’ diet and exercise changes resulted in lower triglycerides, higher HDL, better metabolic function, etc. And what else besides diets could possibly have this effect? Gosh, I thought you’d never ask.

I recently started flossing regularly, partly because it’s good for my teeth but also partly because it’s potentially good for my heart. It seems utterly absurd to think that periodontal disease really causes heart disease, and I’m inclined to think that either the studies that found the association were flawed, that there’s a serious correlation/causation mixup going on, or that the causation actually runs the other way and heart disease causes unhealthy gums. But what the heck, right? I’ve got no illusions that healthy behaviors will make me immortal, but I’d like to put off dying as long as possible. Why not do something that might potentially keep me from getting sick?

Well, there are also flawed, correlation-and-causation-confusing studies out there saying that losing weight will lower my risk of heart disease. The research is no better than the gum research, the conclusions are no more solid, but they might not be a hell of a lot worse. If I’m willing to take one dubious approach to improving my heart health, why not another?

Here’s why: Because if flossing doesn’t prevent heart disease, what’s the worst that’s happened? I’ve got healthier teeth and gums and my dentist is happy with me. If I try to diet my way into weight loss, the consequences are a little more dire: I risk disordered eating, anxiety, depression, undernourishment, low self-esteem, immune suppression, metabolism changes, and weight cycling (not to mention becoming totally boring). Even in the unlikely case that it isas simple as that, that weight directly correlates with heart disease risk, it’s not clear that I’d come out ahead. Flossing means undertaking an immediately healthy behavior in the hopes that its ill-proven future health effects also turn out to be real. Dieting means undertaking an immediately unhealthy, unpleasant, and eventually counterproductive series of behaviors in the hopes that its ill-proven future effects might outweigh present misery. (Oh, and of course I would become totally pretty. But it’s all about health, dontcha know.)

Some stuff that’s healthy, or might be healthy, is worth doing. These things vary according to what’s healthy for your individual body — someone with a torn meniscus might not find it healthy to jog, for instance — but it’s a sure bet that some things will make you feel better over the long and short run, and might even make you less likely to get sick. But it’s also a sure bet that you’re not going to live forever, not even if you do every supposedly healthy thing you can think of — and you don’t have to do them all to benefit from some. What that means to me is that it’s a no-brainer to miss out on things some study says are potentially healthy if they’re also going to cause me immediate harm. If I’m worried about heart disease, I can floss (definitely helps teeth), exercise (definitely helps mood and sense of well-being), and eat foods high in antioxidants (definitely delicious). Or I can try desperately, painfully, and ultimately unsuccessfully to lose weight. Even if the disease-avoiding benefits of the latter are much higher, and there’s no good reason to believe they are, deciding to give it a miss because it’s horrible doesn’t cancel out the benefits of the first three. And if none of them keep me from getting heart disease, which is also quite possible? Well, then I’ll have clean teeth, a good mood, and tasty things to eat, and I’ll die just like the thinnest person alive.

It’s great to do stuff that you find is good for you — you deserve that kind of care. But be aware that there’s not a lot we know about the long-term effects of our daily choices, and what we know is changing all the time. Is it really worth it to ruin your “now” in the hopes of maybe possibly tacking a few years onto your “later”? You can find a version of “healthy” that works for you — that decreases pain rather than increases it, that improves mood rather than wrecking it, that contributes to your quality of life rather than considering “quality of life” an affront to Puritan virtue. Figuring out what will extend your life is a guessing game. Figuring out what will make it enjoyable? That’s not nearly as hard.